Evaluation of dapoxetine treatment success in lifelong premature ejaculation patients with penile sympathetic skin response

Abstract

Hyperactivity of the sympathetic nervous system may play an important role in primary premature ejaculation (PPE), and dapoxetine, a selective serotonin reuptake inhibitor, plays a role in its treatment. We evaluated the success of dapoxetine treatment in PPE patients with a penile sympathetic skin response (PSSR). Of 63 patients who were admitted to our outpatient clinic between March 2017 and December 2017 with a complaint of premature ejaculation and diagnosed with PPE, 56 completed treatment (minimum 12 tablets) with on-demand use 30 mg of dapoxetine and returned for a follow-up appointment. Before and after treatment, the International Index of Erectile Function (IIEF-5) and Arabic index PE (AIPE) scores, intravaginal ejaculation latency time (IELT), testosterone values and PSSR values were compared. The IELT and AIPE values increased significantly in the 56 patients who were re-evaluated after dapoxetine treatment. No significant changes were observed in testosterone levels and IIEF-5. In the PSSR measurement, while the amplitude decreased, the latency was prolonged significantly. PSSR may be an important determinant in the measurement of dapoxetine treatment success for PPE patients, but additional studies are needed.

Aberrant default mode network and auditory network underlying the sympathetic skin response of the penis (PSSR) of patients with premature ejaculation: A resting‐state fMRI study

“…In addition, PSSR latencies had positive relationships with ReHo values of the left precuneus 2 and right middle temporal gyrus: temporal pole (sPE > HC) and had negative relationships with ReHo values of the left median cingulate and paracingulate gyri (sPE < nsPE) (Table 3; Figure 5).…”

“…PE is defined as “consistently ejaculating within one minute or less of vaginal penetration” over a period of “at least six months” and “experienced 75%–100%" of the time in the Diagnostic and Statistical Manual of Mental Disorders (DSM‐5). Hypersensitivity of the penile and sympathetic nervous system is considered as the pathologic mechanisms of PE 2,3 . PE patients were found to have hyperexcitability of the penile sensory pathway including the penile shaft and glans, which was characterized by shorter somatosensory evoked potentials of dorsal nerve (DNSEP) and glans penis (GPSEP) 4 .…”

“…Hypersensitivity of the penile and sympathetic nervous system is considered as the pathologic mechanisms of PE. 2,3 PE patients were found to have hyperexcitability of the penile sensory pathway including the penile shaft and glans, which was characterized by shorter somatosensory evoked potentials of dorsal nerve (DNSEP) and glans penis (GPSEP). 4 In addition, hyperexcitability of the sympathetic nervous system function was also found in PE patients based on the measure of sympathetic skin response located in the penis (PSSR).…”

Association of NE, leptin, and 5‐HT with electrophysiological parameters in patients with primary premature ejaculation

“…In addition, the speculation that ejaculation latency could be related to the basic state of sympathetic nervous system (SNS) during the sexual behavior receives more and more attention . Sympathetic skin response located in the penis (PSSR), a promising method to evaluate the sympathetic innervations of the penis, may be a predictor of the response to selective serotonin reuptake inhibitors (SSRI) treatment in PPE patients , …”